The week 22 Pneumonia and
Influenza (P&I) deaths for El
Paso, Texas set another
weekly record. The 10 deaths raised the total for the past 9
weeks to 116. In the past 9 weeks, record levels were reported
for weeks 14, 15, 18, 19, 20, 21 and 22. Thus, even though week
22 is two weeks
after the official end of the 2010/2011 flu season for the northern
hemisphere, deaths in El Paso remain at record double digit levels. The
P&I death rate for these nine weeks continues at a rate that is
above 12%, which is more than 1.5 times the national epidemic threshold
for the period.

The spike in deaths began in week 14, when the 19 reported deaths were
1 death shy of the weekly record reported for El Paso in the past 15
years at the CDC website, which maintains the weekly data fro the top
122 cities in the US over the past 15 years. The record of 20 was
broken in week 15, when 24
deaths were reported. The numbers declined in weeks 16 and
17, but a new weekly record has been set for each of the past 5 weeks,
even though lab confirmed cases have steadily declined to baseline
levels as the flu season ended.

The record number of P&I deaths in El Paso has not been addressed
by local or national agencies and these high levels are not reflected
in lab confirmed cases raising concerns that the sampling and
associated testing grossly under estimates the number of influenza
deaths, particularly for H1N1. In the past 9 weeks the number of
deaths in the 25-64 age group has been over represented, providing
additional data linking the spike in deaths to unreported / undetected
H1N1 infections, consistent with the linkage between the start of the
increases and the outbreak of Chihuahua H1N1 across the border in Juarez,
Mexico.

This outbreak lead to a pandemic
alert, and the above data suggests that the cases are grossly under
represented by the lab confirmed numbers. The pandemic alert was
linked to the detection of the D225N
receptor binding domain (RBD)
change in the upper
respiratory tract of severe and fatal cases, but sequences
demonstrating a high frequency of D225N in Chihuahua have been withheld.

The withholding of these sequences, and the lack of comment on the
record number of deaths in El Paso, continue to raise pandemic concerns.